A Solution for Sufferers of Sinusitis: Balloon Sinuplasty

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Sinusitis can be a real pain in the nose. This condition, which is an inflammation of the tissue lining the sinuses, ranges in severity from acute to chronic.

Normally, your sinuses are filled with air, but when they become blocked and filled with fluid, germs can grow and cause an infection. When this happens, you can typically be treated with decongestants, steam inhalations, nasal drops or sprays. If a simple sinus infection lasts longer than four or five days, your doctor may prescribe antibiotics.

About 37 million Americans suffer from at least one episode of sinusitis each year.

But, when it comes to chronic sinusitis, symptoms and treatment become a little more complicated. Patients may deal with two or more of the following symptoms for eight or more weeks:

• Facial congestion/fullness
• A nasal obstruction/blockage
• Pus in the nasal cavity
• Fever
• Nasal discharge/discolored postnasal drainage

Other symptoms may be headaches, bad breath, fatigue and dental pain. When typical treatments fail, a procedure called balloon sinuplasty may be considered.

"Balloon sinuplasty is a tool we use to dilate or enlarge the natural openings of the sinuses to improve drainage," said Dr. Kenneth Einhorn, chief of Abington Memorial Hospital's Division of Otolaryngology. The procedure involves a small, flexible, balloon catheter opening up blocked sinus passageways, allowing improved aeration and promoting the drainage of the mucus that builds up in patients suffering from chronic sinusitis symptoms.

Balloon sinuplasty is typically reserved for patients who have chronic sinusitis who have exhausted other medical therapies for the condition, such as antibiotics and allergy therapy.

"If these have failed, a patient may be a good candidate for balloon sinuplasty," Dr. Einhorn stated.

For about 25 years, doctors relied on a procedure called endoscopic sinus surgery (ESS). Standard ESS surgery involves a doctor inserting an endoscope into the nose, providing the doctor with an inside view of the nasal walls. From there, the doctor uses instruments to remove small amounts of bone, tissue or other material blocking the sinus openings and removes growths (polyps) of the mucous membrane.

However, as with most surgeries, standard ESS carries some risks including vision impairment, leakage of cerebral spinal fluid, severe bleeding and scarring. While these risks are rare, Dr. Einhorn said to date there have been close to zero complications with balloon sinuplasty when used alone.

"It's absolutely becoming more popular in the general ear, nose and throat doctor community because some of the advantages it offers," he stated.

The number one reason doctors like using balloon sinuplasty as a stand-alone procedure or in conjunction with standard ESS techniques is because they can avoid cutting or potentially damaging any tissue.

"We feel that it's less likely to damage the surrounding normal function of the tissue. Sinus tissue is different from other types of tissue – it is constantly clearing mucus. If you cut away too much tissue, you could damage some of the normal function so that it doesn't clear mucus out through the sinus openings properly," Dr. Einhorn explained.

Some of the other advantages of balloon sinuplasty include patients being able to resume work much sooner than some other types of sinus surgery and with minimal post-operative pain. Most patients can return to work in two days.

Sometimes, this procedure alone cannot open all of the sinuses.

"Depending what sinuses are needed to be opened, standard ESS techniques may need to be utilized in combination with balloon sinuplasty or alone," he said.

Balloon sinuplasty has also been proven effective.

"There are two very good studies – one study shows that at two years post surgery, 85 percent of patients were symptom free. There's another study that showed that 92 percent of patients were symptom free 18 months after surgery. That's a very good success rate," Dr. Einhorn said.

Although the symptoms of sinusitis aren't life threatening, they do affect daily life.

"The symptoms interfere with normal, everyday functions. We feel that perhaps the most important result of balloon sinuplasty is when their symptoms are gone or significantly improved," Dr. Einhorn said.